PL-12-1728Miami Shores Village CJ
Building Department SEP 1 7 2012
90050 N.E.2nd Avenue, Miami Shores, Florida 33138 �
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
&6-N
) -1/4- FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. e LI 'Z- v(3
Permit Type: PLUMBING
JOB ADDRESS: i
City: Miami Shores County: Miami Dade
Folio/Parcel#: 3� C>r, —" U- -1 C)
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titlehold r):_ UD
Address: n L=' qZ T
City: YhlC, k,c. , i1 State:
NO Flood Zone:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
R
�7
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address: Sir
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ .! cb Square/Linear Footage of Work:
Type of Work:
Description of Work:
❑Alteration `` ❑Newl ❑Repair/Replace ❑Demolition
36 �a l�� LJ J-�J�
Submittal Fee $iU'-Permit Fee $ /;9 ® CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
w
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State
Zip
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, accertified copy of the recorded notice of commencement must be posted at the job site
for t the
eionst ill not inspecti approved and a reinspectidn'1 ,yf,--t�ebuilding permit is issued. In the absence of such posted notice, the
Signature Signature_
Owner or Agent
The foregoin trument was acknowledged befo e me this
day of , 21 L by � Li
who is personally known tome or who has produced
As identification and who did take an oath.
Contractor
The foregoing instrument was acknowledged before me this
day of & 2013-, by k)a l ,
who is .personall kn to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: kx,
Print: '• Print: a
_ "= Notary Public - State of Florida Bridget Hobart
My Commission E ver My Comm. Expires Apr 19, 2015 My Commission My Commission DD938964
r !,,dLjE.Pres
i11/09/2013
�o �;:� Commission # EE 65898
APPROVED BY < Plans Examiner Zoning
Structural Review Clerk
(Revised3/1212012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
The Ames II&za East Condombduin AssockWon, Inc.
745 North East 910' Street
Miami Shores, FL 33138
305-759-9069 / FAX 305-759-2101
E-MAIL sr)el23@att.net
September 7, 2012
Miami Shores Village
Building Dept.
10050 NE 2nd Avenue
Miami Shores, FL 33138
Dear Sir / Madam:
This letter will serve as Z, confirmation that Mr. Cecilio Acosta, owner of
Apt. 2K, at 726 NE 92n Street, Miami Shores, Fla. and Service America, are
fully authorized by the Board of Directors of the Shores Plaza East
Condominium Association to have a new "water heater" installed at said
apartment.
Should you have any questions regarding the enclosed, please feel free to
contact the condominium office.
Sincerely yours,
(It S-�- -�,/
Rrnzalez
President
cc: file